Patient selection: lung resection
Outcome: major cardiac complications in the perioperative period or up to 30-days afterwards – acute myocardial iinfarction, pulmonary edema, ventricular fibrillation, complete heart block, cardiac arrest, cardiac-related death
Parameters:
(1) ischemic heart disease
(2) history of transient ischemic attack (TIA) or stroke (cerebrovascular disease)
(3) serum creatinine in mg/dL
(4) tpneumonectomy planned
|
Parameter
|
Finding
|
Points
|
|
ischemic heart disease
|
no
|
0
|
|
|
yes
|
1.5
|
|
history of TIA or stroke
|
no
|
0
|
|
|
yes
|
1.5
|
|
serum creatinine
|
<= 2 mg/dL
|
0
|
|
|
> 2 mg/dL
|
1
|
|
pneumonectomy planned
|
no
|
0
|
|
|
yes
|
1.5
|
where:
• Ischemic heart disease may include: therapy with nitrates, history of myocardial infarction, history of positive exercise test, ischemic chest pain, pathologic Q waves on ECG.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maxium score: 5.5
• The higher the score the greater the risk of a major cardiac complication.
|
ThRCRI
|
Risk Class
|
Major Cardiac Complication
|
|
0
|
A
|
1 to 1.5%
|
|
1 to 1.5
|
B
|
4 to 6%
|
|
2 to 2.5
|
C
|
8 to 19%
|
|
3 to 5.5
|
D
|
18 to 23%
|
